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. 2021 Mar;11(1):98-104.
doi: 10.2991/jegh.k.200928.001. Epub 2020 Oct 3.

Clinical Characteristics and Predictors of 28-Day Mortality in 352 Critically Ill Patients with COVID-19: A Retrospective Study

Abdulrahman Alharthy  1 , Waleed Aletreby  1 , Fahad Faqihi  1 , Abdullah Balhamar  1 , Feisal Alaklobi  2 , Khaled Alanezi  1 , Parameaswari Jaganathan  3 , Hani Tamim  4 , Saleh A Alqahtani  5   6 , Dimitrios Karakitsos  1   7 , Ziad A Memish  3   8   9
Affiliations

Clinical Characteristics and Predictors of 28-Day Mortality in 352 Critically Ill Patients with COVID-19: A Retrospective Study

Abdulrahman Alharthy et al. J Epidemiol Glob Health. 2021 Mar.

Abstract

Background: Since the first COVID-19 patient in Saudi Arabia (March, 2020) more than 338,539 cases and approximately 4996 dead were reported. We present the main characteristics and outcomes of critically ill COVID-19 patients that were admitted in the largest Ministry of Health Intensive Care Unit (ICU) in Saudi Arabia.

Methods: This retrospective study, analyzed routine epidemiologic, clinical, and laboratory data of COVID-19 critically ill patients in King Saud Medical City (KSMC), Riyadh, Saudi Arabia, between March 20, 2020 and May 31, 2020. Severe acute respiratory syndrome coronavirus-2 infection was confirmed by real-time reverse transcriptase polymerase chain reaction assays performed on nasopharyngeal swabs in all enrolled cases. Outcome measures such as 28-days mortality, duration of mechanical ventilation, and ICU length of stay were analyzed.

Results: Three-hundred-and-fifty-two critically ill COVID-19 patients were included in the study. Patients had a mean age of 50.63 ± 13.3 years, 87.2% were males, and 49.4% were active smokers. Upon ICU admission, 56.8% of patients were mechanically ventilated with peripheral oxygen saturation/fraction of inspired oxygen (SpO2/FiO2) ratio of 158 ± 32. No co-infections with other endemic viruses were observed. Duration of mechanical ventilation was 16 (IQR: 8-28) days; ICU length of stay was 18 (IQR: 9-29) days, and 28-day mortality was 32.1%. Multivariate regression analysis showed that old age [Odds Ratio (OR): 1.15, 95% Confidence Intervals (CI): 1.03-1.21], active smoking [OR: 3, 95% CI: 2.51-3.66], pulmonary embolism [OR: 2.91, 95% CI: 2.65-3.36), decreased SpO2/FiO2 ratio [OR: 0.94, 95% CI: 0.91-0.97], and increased lactate [OR: 3.9, 95% CI: 2.4-4.9], and D-dimers [OR: 2.54, 95% CI: 1.57-3.12] were mortality predictors.

Conclusion: Old age, active smoking, pulmonary embolism, decreased SpO2/FiO2 ratio, and increased lactate and D-dimers were predictors of 28-day mortality in critically ill COVID-19 patients.

Keywords: COVID-19; D-dimers; active smoking; intensive care unit; lactate; mortality; pulmonary embolism.

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Conflict of interest statement

Given his role as Editor in Chief, Ziad Memish had no involvement in the peer-review of this article and has no access to any information regarding its peer-review. Full responsibility for the editorial process for this article was delegated to Dr. Shahul Ebrahim. All other authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Study flowchart.
Figure 2
Figure 2
Kaplan-Meier survival curves integrating different age groups of COVID-19 patients that were hospitalized in the intensive care unit (ICU).
See this image and copyright information in PMC

References

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